Regular exercise helps keep joints moving, restores and preserves flexibility and strength, and protects joints against further damage. It improves your coordination, endurance and your ability to perform daily tasks (such as walking or writing).

Exercise also can lead to mood enhancement, an improved sense of self-esteem and a sense of accomplishment.

Why Water Exercise?

• The soothing warmth and buoyancy of warm water make it a safe, ideal environment for relieving arthritis pain and stiffness.
• Immersing in warm water raises your body temperature, causing your blood vessels to dilate and increasing circulation.
• Water exercise is a gentle way to exercise joints and muscles.
• Water supports joints to encourage free movement, and may also act as resistance to help build muscle strength.
• Using a spa adds a component to the therapy – massage. Jet nozzles release warm water and air, massaging your body and helping you relax tight muscles.

Talk with your doctor to determine whether water exercise is appropriate for you.

Water Exercise at Home

If you obtain benefits from water exercise, you may want to consider installing a pool or purchasing a spa (hot tub) for your home.

The size and shape of a hot tub will determine the types of exercises you can do in it. Some may limit you to working the smaller joints and muscle groups.

A spa or pool provides buoyancy that helps you to relax and exercise your joints. Pools offer more space than hot tubs, allowing for more vigorous exercises, including strengthening and aerobic exercises.

If your doctor or other health professional advises you to follow a regular program of water exercises, part or all of the purchase price may qualify for income tax deduction as a medical expense. Be sure to get information on specific tax rules from your lawyer or accountant before installing a pool or spa.

Using a Pool or Hot Tub Safely

The use of heat is recommended for many people with arthritis and related conditions, but not all. Your doctor can help you determine if it is appropriate for you.

Benefits of heat can include:

• muscle relaxation
• decreased pain and stiffness
• greater ease when performing exercises and daily activities.

If you are exercising in warm water, keep the following tips in mind:

• EZ Riverly hot water is not safe and is not necessary to get results; mild heat is just as effective and easier for the body to tolerate.
• The water temperature should feel soothing and comfortable, not hot. In a pool, water temperatures from 83 to 88° F are usually comfortable for exercise.
• If you are just soaking or doing very gentle movements while sitting in a spa, you can usually tolerate slightly higher temperatures.
• New hot tub users should vary the temperature and length of stay until they can determine what is most comfortable. Start slowly, and extend the time in the spa as you feel comfortable.
• For most people, soaking time should not exceed 10 to 15 minutes at temperatures between 98 and 104° F.
• Remember that children and elderly people are more prone to become overheated and may need to soak for less time.

Medical Precautions

If you own a spa or pool, use it safely. Ask your sales representative for a booklet containing general safety tips and be sure to follow these medical precautions:

• Consider that you may need help getting in and out of the spa or pool. Have someone nearby to help you if necessary.
• Consult your doctor before using or purchasing a spa or pool if you have any special medical conditions such as: lung or heart disease, circulatory problems, high or low blood pressure, diabetes, multiple sclerosis, skin irritations or any other serious illness.
• Check the thermometer for appropriate temperature before entering and while in the spa or pool.
• Remember that individuals react differently to heat; if you start to feel lightheaded or nauseated, get out of the water immediately.
• If joint swelling, stiffness or pain increase, discontinue the use of heat and exercise and consult your doctor.
• Never use a pool or hot tub during or after drinking alcohol or using drugs. These may cause sleepiness, drowsiness or changes in blood pressure.
• Pregnant women should not enter a hot tub without first consulting their doctor.

Exercise in the Pool or Hot Tub

When first entering a spa or pool, relax and enjoy the soothing water. When your muscles and joints feel more comfortable and relaxed, slowly begin your exercise routine. Allow enough time after exercising to relax muscles again before getting out of the water.

You can order the free brochure, "Water Exercise: Pools, Spas and Arthritis," to get examples of specific exercises that might benefit you. Please discuss with your doctor any new exercise program before you begin.

Water Exercise Programs

The Arthritis Foundation Aquatics Program (AFAP) is a water exercise program designed for people with arthritis and related conditions. Classes are usually conducted 2 to 3 times per week at local indoor pools for 45 to 60 minutes. Joining a water exercise class gives you the opportunity to exercise in warm water, with guidance from a trained instructor. For more information about AFAP and other arthritis exercise programs, contact your local office of the Arthritis Foundation.

Cautions

Because there are many effective and safe ways to minimize pain and loss of motion from arthritis, you need to work with your doctor and other appropriate health professionals to develop an effective, individualized treatment program. Your specific program will depend on:

• The type of arthritis you have
• How it affects you
• The severity of the disease
• The joints affected.

Your age, occupation and everyday activities also influence which treatment program is right for you. Your treatment will probably include a combination of:

• Rest and relaxation
• Exercise
• Use of heat and warm water
• Use of cold
• Joint protection
• Self-help aids

The Arthritis Foundation gratefully acknowledges Helen M. Tilden, RN, for her assistance with this booklet.